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General NPI Number Information
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NPI Number | 1457739187
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Entity Type | Individual
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Provider Name | JOHN RIZZI PH.D., LCSW
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Gender | Male
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Dates
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Enumeration Date | 05/14/2015
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Last Update Date | 01/04/2016
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Provider Practice Location Address
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Address Line | 140 RIVERSIDE DR 1-O
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City | NEW YORK
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State | NY
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Zip | 10024-2605
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Country | US
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Telephone | 516-655-1025
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Fax |
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Provider Business Mailing Address
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Address Line | 639 W END AVE APT 15C
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City | NEW YORK
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State | NY
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Zip | 10025-7343
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Country | US
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Telephone | 516-655-1025
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0831421
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License Number State | NY
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